| NPI | 1427174762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA ROGERS Billing Coordinator 850-623-2948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2010-04-30 |